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目的评价髁状突骨折手术治疗的临床效果。方法选择2009—2013年在大连市中心医院口腔颌面外科收治的髁状突骨折患者56例(64侧),根据骨折位置不同分别采用耳屏前入路(19侧)、经颌后切口穿腮腺入路(23侧)和颌后颌下入路(22侧)进行手术治疗,观察其临床效果和术后并发症发生情况。结果 3种手术入路治疗髁状突骨折总体临床效果满意,但部分病例合并面神经损伤、张口受限、咬合错乱、髁状突吸收、皮下积液等并发症。结论髁头骨折可采用耳屏前入路;髁颈部骨折可采用经颌后切口穿腮腺入路;髁颈下骨折可采用颌后颌下入路。髁头骨折一般采用1~2枚侧向拉力螺钉固定;髁颈和髁颈下骨折可采用1~2枚微型钛板坚固内固定,但有1枚钛板必须沿张力带放置。
Objective To evaluate the clinical effect of surgical treatment of condylar fractures. Methods Sixty-six patients (64 sides) with condylar fractures admitted to Dalian Central Hospital from 2009 to 2013 were divided into two groups: Parotid approach (23 side) and maxillary and submandibular approach (22 sides) for surgical treatment, to observe its clinical effect and postoperative complications. Results Three kinds of surgical approaches were satisfactory for the treatment of condylar fractures. However, some cases were complicated with facial nerve injury, limited mouth opening, occlusion, condyle absorption and subcutaneous effusion. Conclusions Condylar head fractures can be treated with trabeculectomy. The condylar and neck fractures can be treated with the parotid gland via posterior maxillary incision. The mandibular submandibular fractures can be treated with submandibular approach. Condyle fractures are generally used 1 to 2 lateral tension screws; condylar neck and condyle neck fracture can be 1 to 2 micro-titanium plate fixation, but there is a titanium plate must be placed along the tension band.